title: Factors predicting early deterioration in mild brain trauma: a prospective study.
abstract: OBJECTIVE
  To evaluate risk factors for clinical deterioration in mild traumatic brain injury.
  
  
  METHODS
  Prospective cross-sectional.
  
  
  METHODS
  This study evaluated 203 patients with mild traumatic brain injury. A brain computed tomography scan was performed in all patients and they were observed for 6-48 hours.
  
  
  RESULTS
  Among these patients, 2.5% had cerebral contusions and the most common sites for contusions were frontal lobes; 94% of patients had no hematoma in the initial scan, while 3% had subgaleal haematoma, 1.5% had subdural haematoma, 1% showed subarachnoid haemorrhage, 0.5% intracerebral haemorrhage and 0.5% epidural haemorrhage. GCS was 15 in 96.6% and 13-14 in 3.4%. GCS deteriorated in three (1.5%). Presence of coagulopathy, anticoagulant drug use, GCS of 13-14 and increased age predicted further deterioration. Among CT findings, those with midline shift, cerebral contusion and diffuse cerebral oedema deteriorated more. Among different haematoma types, only SDH predicted a worse outcome.
  
  
  CONCLUSIONS
  Although deterioration rarely occurs in patients with mild brain injury, those with coagulopathy, anticoagulant drug use, GCS of 13-14, increased age, midline shift, cerebral contusions, diffuse cerebral oedema and SDH were more prone to deterioration.
authors.affiliation: Department of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran .
authors.forename: Amir Saied
authors.initials: AS
authors.lastname: Seddighi
authors.forename: Rouzbeh
authors.initials: R
authors.lastname: Motiei-Langroudi
authors.forename: Homa
authors.initials: H
authors.lastname: Sadeghian
authors.forename: Mohsen
authors.initials: M
authors.lastname: Moudi
authors.forename: Alireza
authors.initials: A
authors.lastname: Zali
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Asheghi
authors.forename: Reza
authors.initials: R
authors.lastname: Alereza-Amiri
authors.forename: Afsoun
authors.initials: A
authors.lastname: Seddighi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D001930:Brain Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000925:Anticoagulants